DIGITAL

RADIOGRAPHY
Moderator
Mr. Ram Singh (Lecturer)
Deptt. Of Radio-Diagnosis & Imaging
P.G.I.M.E.R
Presented By
SUNIL KUMAR SEKSANA
B. Sc. MT ( Final Year Student )
Deptt. Of Radio-Diagnosis & Imaging
P.G.I.M.E.R
 INTRODUCTION
DIGITAL RADIOGRAPHY (DR) is a
representation of continuous analog
information into digital form by the use of
computer which processes the digital data to
form an image.
Conventional radiography has dominated the
filed of radiography for many years. But it has
always been recognized that Film / Screen
system has certain limitations.
LIMITATIONS OF FILM / SCREEN
SYSTEM
Exposure error permanent on image.
Faults in the film can lead to repeat the
examination.
Delay in viewing image.
Dynamic range of the x-ray film is limited.
Difficult to visualize widely varying tissue.
Storage and retrieval cost.
Copied radiographs are of inferior quality than
the original one.
3
These limitations can be
overcome by the incorporation of
Computer Technology into the
diagnostic X-ray imaging.

4
 MILESTONE IN DIGITAL RADIOGRAPHY
Year Development

1977 Digital subtraction angiography.

1980 Scan projection Radiography.
1983 Computed radiography (CR) storage phosphors.
1990 Charge-coupled device (CCD) slot-scan direct
radiography (DR).
1994 Selenium drum DR.
1995 Selenium-based flat-panel detector.
1995 Amorphous silicon–cesium iodide ( scintillator )
flat-panel detector.
1997 Gadolinium-based ( scintillator ) flat-panel detector.
2001 Dynamic flat-panel detector fluoroscopy.
5
 SOME IMPORTANT DEFFINITION
PIXEL:- An abbreviation of the term 'picture element.' A
pixel is the smallest picture element of a digital image.
A monochrome pixel can have two values, black or
white/1 or 0.
VOXEL:– An abbreviation of the term ‘volume element.’
The smallest distinguishable box-shaped part of a 3D
space.

6
 WHAT IS A DIGITAL IMAGE?
Collection of pixels laid out
in a specific order with width
(x) and height (y) in pixels .
• Each pixel has a numerical
value which correspond to
gray scale value.

PIXEL
NUMERICAL VALUE

7
 PIXEL SIZE

IMAGE MATRIX
SIZE SIZE
(mm) (pixels)

Image size
Pixel size =
Matrix size

Image size – Dimension of the field of view ( FOV ) within the patient’s
body, not the size of a displayed image.

Matrix size – Number of pixels along the length and width of an image.
8
SCAN PROJECTION RADIOGRAPHY

It is the method of obtaining high resolution digital X-ray

images which requires the motion or scanning of an X-
ray beam during the image acquisition.
It is the process of generating an X-ray projection
radiograph by scanning with a fan beam of 2 – 10 mm
thick and arced with 30* - 40*. Earlier Scan projection
radiography (SPR) was performed on a computer
tomography CT system by translating the patient through
the CT gantry aperture.

9
COMPONENTS OF S.P.R. SYSTEM
X-Ray Tube.

- of high heat loading capacity (usually above 1 MHu ) is required because

of long imaging time & detector efficiency. Usually 20 – 50 cm body part
of patient is imaged at a translation speed of 1 – 20 cm/s.
Pre-Patient Collimator.
Post-Patient Collimator.
Detector Array.

10
ADVANTAGE

1. High radiographic contrast.

2. Low contrast detectibility.
3. Image manipulation.

DISADVANTAGE

1. Poor spatial resolution.

2. Scanning time is more.
3. More radiation dose to the patient.
11
12
COMPUTED RADIOGRAPHY - CR

Conventional Cassette is replaced by a

cassette containing imaging plate ( IP ).
Cassette is exposed in the same manner
as conventional cassette.
Latent image is formed in imaging plate.
Latent image is made visible by processing
the imaging plate into the reader.

13
 COMPONENTS OF CR SYSTEM

CR Cassette with
Imaging plates
ID Tablet
Image reader
Image Processor
Image recorder

14
CR CASSETTE WITH IMAGING PLATE
Material
• Body: ABS ( Acrylonitryl butadiene
styrene)
• Corners: PUR (Polyurethane rubber)
• Hinges: PP (Polypropylene)
• Inner lining: felt
Sizes
Same as that of conventional
cassette.
Identification
• Embedded memory chip
• Contactless RF identification
Backscatter protection
• 150 μ lead
Weight
• 35 x 43 cm typical 1.6 kg

15
Imaging Plate PROTECTIVE LAYER

PHOSPHOR LAYER

Protective layer ANTI-HALO & REFLECTIVE LAYER

Fluorinated polymer material
Phosphor Layer BASE
Ba FX: Eu +2

Anti-halo Layer + Reflecting BACKING LAYER

Layer
- prevent laser from passing
through.
Base:-
PET- Polyethylene teraphtalate
Backing Layer
protects the base from
damage.

16
 IMAGE READER
After exposure the cassette is
transferred to reader system
Cassette is opened automatically and
the imaging plate is transported for
scanning by laser beam (He.Ne)
It stimulate luminescence proportional
to the X-Ray energy absorbed
Luminescence signals are converted
into electrical signals by
photomultiplier tubes.
Electrical signals are sampled and
converted into digital signal by an ADC
The digital data is processed to form
an image which is displayed on the
monitor

17
What Happens to the Plate in the Reader?

2. Image plate is
1. Cassette and
removed from
image plate enter the
cassette
reader

5. Image plate is 3. Latent image is

returned to cassette
scanned by laser
and ejected

4. Image plate is
erased with high
intensity light

18
19
20
21
 ADVANTAGE OF CR SYSTEM
- No special equipment is required.
- Because of wider exposure latitude more information from
the x-ray beam will be extracted.
- Repeat becomes a matter of positioning rather than
exposure factors.
- All types of radiography is possible with CR system.
- The image on the CRT can be manipulated in a variety of
ways i.e. contrast enhancement, edge enhancement, black /
white reversal (post processing).
- Elimination of lost radiographs.
- Simplification in filing the images.
- Increased capability for consultation made possible by
electronic transmission of digital images (networking system).

22
CCD Slot Scan Direct Radiography

23
24
 Selenium Drum DR System
Rotating selenium-dotted drum, which has a positive electrical surface
charge, is exposed to x-rays. During exposure, a charge pattern
proportional to that of the incident x-rays is generated on the drum surface
and is recorded during rotation by
an analog-to-digital converter .
Advantage:-
provide good image quality that is
superior to that provided by
screen-film or CR systems.
Disadvantage:-
because of their mechanical design,
selenium drum detectors are
dedicated thorax stand systems
with no mobility at all.

25
 DIRECT RADIOGRAPHY

Direct radiography – DR (sometimes termed direct digital

radiography or even digital radiography)
1. flat panel detectors - FPD
a. direct conversion - converts x-ray energy directly into an
electrical signal.
b. indirect conversion - converts x-ray energy into light
signal then into electrical signal.
2. charge coupled device - CCD
- x rays interact with phosphor which emits light.
- CCD captures emitted light and stores energy as
‘trapped” electrons.
- stored electrons are ‘read out” and converted to digital
signal.

26
27
28
29
30
 PRINCIPLES OF DIGITAL RADIOGRAPHY
As screen-film radiography serves detector
and storage medium both, digital detectors
are used only to generate the digital image.
The digital image then stored on a digital
medium. Digital imaging comprises four
separate steps:
 generation.
 processing.
 archiving.
 presentation of the image.
31
 DIRECT DIGITAL IMAGING
Components required for
direct digital image
production are
- X-ray source.
- An electronic sensor.
- Computer
- Analog to Digital converter
(ADC).
- Screen monitor.
- Printer.

32
INDIRECT DIGITAL CONVERSION
-Indirect conversion of x-rays to electric
signal.
-Phosphor converts X-rays to light and
photodiode converts emitted light into
electrical signals.
-Commonly used phosphors are thallium
doped Cesium Iodide or Gadolinium Oxy-
Sulphide.
-Less sensitive to ambient temperature
variations.
33
34
 COMPONENT
1. Cesium Iodide (Scintillator) Benefit
- needle structure provides high
resolution and absorption ◆ high spatial resolution, excellent
- outgoing light spectrum ideally matches
image quality within a wide kV range
aSi sensitivity ◆ capability for lower dose
- high DQE (Detective Quantum Efficiency)

2. Amorphous Silicon Matrix

- industry standard for large area electronics ◆ high resolution over a large area
- high stability with respect to X-ray
- the only effective way to obtain images
◆ high reliability and cost effectiveness
for radiography a n d fluoroscopy

3. Optimized Electronics ◆ the quality and availability of images

- high signal to noise ratio is equal or superior to film
- fast and efficient reading of line discs
together with readout ICs ◆ fast image acquisition

35
 MONITOR

Important part of overall digital system

Primary viewing station should have high
quality monitor
Considerations
1. LCD vs. CRT
2. luminance or brightness
3. contrast ratio
4. resolution

36
 DICOM
Digital Image &
Communication in
Medicine
Is the digital imaging
standard that allows
images to be shared or
moved between different
pieces of equipment from
different manufacturers
securely.
Essential for teleradiology
and communication
between other DICOM
systems.
PACS
Picture Archival and
Communication System
• Used for storage and
distribution of digital images.
• Allows one to have all others
previous exams available for
comparison.
• Allows multiple simultaneous
viewing.
37
 ADVANTAGES OF DDR
- Increased workflow efficiency, saving time and labour.
- Very short exposure time, eliminating motion blur ( as
high powered integrated x-ray system).
- Auto selection of filter and focal spot size.
- Automatic tracking for easy positioning.
- Automatic exposure control facility reduce the chance
of repeat.
- Immediate availability of image for quality check and
diagnosis.
- virtually no missing images due to digital storage

38
 LIMITATIONS OF DDR

- High initial cost.

- Some radiographic views are difficult as
detectors are not free to be placed in any
position.

39
 CR vs. DR
CR –
- more flexible.
- lower cost.
- Portable (still have to use CR reader to
process cassette, image available in 90 sec)
DR –
- higher throughput (images within few
seconds).
- more expensive.
- Portable – generally thought to have best
quality image.

40
Dynamic flat-panel detector fluoroscopy

Dynamic detector: Integris Allura

41
Scintillator: CsI:Tl needle crystals

Thickness 550µm
 good X-ray
absorption

Needles act as
light-guides
 sharp MTF

CsI:Tl emits
green light

42
Photodiode array: a-Si technology

Same technology
as used in active
matrix LCDs
(TFT displays)

a-Si photodiodes:

high sensitivity
for green light

43
 Integris
Allura
Flat Dynamic
Detector
for Cardio

Scintillator Photodiode array Refresh light

44
 Technical Data
Digital Diagnost Integris Allura FD

Detection static static + dynamic

(up to 30 frames/s)
Field of view 43 cm x 43 cm 18 cm x 18 cm

Number of pixels 3k x 3k 1k x 1k

Pixel size 143 µm x 143 µm 184 µm x 184 µm

DQE(0) ≈ 60 % ≈ 75 %

45
 Technical features of Various Digital radiography System
Feature  Converter Readout Detector Pixel Size Matrix
size

Screen Film Gd2O2S Film 14x17 Grain size- ………..

2
Storage BaFBr:Eu LASER 14x17 200 1760x2140
Phosphor
Slot scan CsI:Tl CCD 17x17 162 2736x2736
CCD
Direct FPD Se Active Se 14x17 139 2560x3072
Matrix
Gd2O2S Active Si 17x17 160 2688x2688
Indirect FPD Matrix
CsI:Tl Active Si 17x17 143 3121x3121
Matrix
46
 IMAGE RECEPTOR COMPARISION
FEATURE FILM PSP DDR
RADIATION DOSE Higher Lower Lower
GENERATION OF Chemical Laser scanner, Computer
VISIBLE IMAGE Computer
IMAGE VIEWING Delayed, View box Delayed, Computer In few seconds, Computer
transillumination monitor monitor

RESOLUTION 16-20lp/mm 6-8lp/mm 8-10lp/mm

CONSTRUCTION Thin, flexible Thin, flexible Thick, rigid, wire

LIFE SPAN Single use Reusable after erasure Reusable

IMAGE Fixed Multiple operations- Multiple operations-

ENHANCEMENT unchangeable Contrast, Density, Contrast, Density,
image Magnification, Magnification,
positive/Negative, positive/Negative,
measurement measurement

STORAGE Patient record Variety of archiving Variety of archiving

method Server, Zip, CD method Server, Zip, CD

47
48
Image Quality Parameters

♦ Dynamic Range & Contrast

♦ Limiting Spatial Resolution

(LSR)

♦ Signal to Noise Ratio (SNR)

♦ Modulation Transfer Function

(MTF) 49
 Contrast / Dynamic Range

Low Contrast

High Contrast

Film-Screen

Detector
50
 Dynamic Range
Contrast levels or film Dynamic range is a
densities generated over a measure of the signal
range of x-ray exposure response of a detector that
levels is exposed to x-rays

Narrow Dynamic Range Wide Dynamic Range

straight
Toe part
Image Brightness

Image Brightness
straight shoulder shoulder

Toe part

X-ray Detected X-ray Detected

51
Limiting Spatial Resolution (LSR)

Resolution

Spatial resolution refers to the minimum resolvable separation

between high-contrast objects. In digital detectors, spatial
resolution is defined and limited by the minimum pixel size.

52
 Signal to Noise Ratio (SNR)
Quantum mottle is an appearance
of noise in the radiographic image
due to low SNR of the information
reaching the image recording
Increasing Contrast

system.

Contrast
Ratio
Sign
al
Nois
e
High Low SNR
Decreasing Noise SNR

53
 obj
SN
ect
R
det
ect

Impact of Noise
abil
ity
2:
incr
1
eas
es
SN
ver
R
Quantum and electronic noise are unavoidable in a digital imaging
y
rapi
dly.
chain. The effect, often expressed as signal-to-noise ratio (SNR),
5:
can vary widely from system to system.
1
SN
R

Signal Useful Image Formation

---------- = --------------------------------------
Noise  Erratic Information
 
 
 
 
 
 
1:1 SNR   2:1 SNR 5:1 SNR
54
 
MTF :- Modulation transfer function (MTF) is the capacity of the
detector to transfer the modulation of the input signal at a given
spatial frequency to its output.

X_Ray Photons

Light Photons

Electrons

Selenium
LANEX No Scattering
CsI
High Scattering Low Scattering “Perfect” MTF
04/17/10 Low MTF Good
SEMINAR - " DIGITAL MTF
RADIOGRAPHY "
 Detective Quantum Efficiency ( DQE )
Detective quantum efficiency (DQE) is one of the
fundamental physical variables related to image
quality in radiography and refers to the efficiency
of a detector in converting incident x-ray energy
into an image signal.

It dependent on
- Radiation exposure,
- Spatial frequency,
- MTF,
- Detector material.
- Quality of the radiation applied (voltage and current).

56
 Artifacts in Digital Radiography
1. image plate artifacts ( In
CR ).

Due to cracking Imaging Plate

57
2. Plate Reading Artifact ( in CR )

Damaged Laser beam head in

Line caused from dirt collected CR reader. Appears as multiple
in a CR Reader. linear white lines.
58
3. Image processing artifacts

Missing lines or pixels ( indicating digitization

59
problems ).
4.operator errors towel used to help in
positioning a child.

Double exposure: Radiographs of Digital detector is MORE sensitive

both feet and pelvis (arrowheads)
on a single film.
60
 CR PHOSPHOR PLATE CLEANER

Dust and dirt build up on CR

phosphor plates, leading to image
artifacts. To avoid this, plates need
cleaning at regular intervals.
Solvent
• Ethanol 99.7%
Additives
• Catanac SN (Cyastat SN 50) 0.3%
Safety
• Highly flammable
• Keep container closed
• Keep away from sources of ignition

61
 Quality Assurance
For Conventional Projection or DR
Radiography: The same rules, theories, and
laws still apply and can not be overlooked
- FFD/OFD (SID/SOD).
- Inverse Square Law.
- Beam Alignment.
- Tube-Part-Film Alignment.
- Collimation.
- Grids.
- Exposure Factors: KVP, mAs.

62
 PERIODIC QUALITY CONTROL
Daily (technologist) Monthly (Technologist)
– General inspection. – Film processor maintenance (if
– Film processor / Laser any).
printer. – Inspect and clean image
receptors.
– Erase imaging plates.
– Review film retake rate.
– Verify digital interfaces and
Semi-Annually / Annually (Physicist)
network transmission. – Evaluate image quality.
Weekly (technologist) – Acceptance tests to re-establish
– Test phantom images. baseline values.
– System cleanliness. – Review.
QC records.
Service history.
63
 CONCLUSION

By their tremendous impact on the image quality,

radiation dose and workflow, digital radiography
systems have become practicable alternatives.
CR is a simple and cost effective technology that
permits use of existing radiographic equipment. It
has been suggested that for moderate work load
( up to 50-60 films per day), a CR system is
adequate.
High cost of a DR system is justified only when the
workload is much beyond this level.
64
65